The Texas Commission on Health and Human Services’ denial of customized power wheelchairs has sparked a lawsuit in federal court.
Plaintiffs Bradley Koenning, 23, Brian Martin, 27, and Morgan Ryals, 25, all three of whom are disabled Medicaid beneficiaries, sued Thomas Suehs, executive commissioner of The Texas Commission on Health and Human Services (HHSC), on Feb. 15.
The plaintiffs claimed they were wrongfully denied customized power wheelchairs with specialized components, including standing capability, based on current HHSC policies.
As Medicaid beneficiaries, the plaintiffs are entitled to necessary and durable medical equipment through the home health benefit of The Texas Medicaid program.
The program, however, excludes coverage of certain durable medical equipment, including customized power wheelchairs with standing capabilities, for persons aged 21 and up, according to the lawsuit.
The exclusion leaves disabled persons like Bradley without equipment that could be beneficial to them.
Bradley, a DeWitt County resident, sustained a spinal cord injury in 2005 after a motocross accident, leaving him paralyzed below the shoulder.
Occupational therapists determined Bradley would benefit from the customized power wheelchair in several ways.
The chair’s switch would allow Bradley to independently drive the wheelchair and access the other power features of the chair, while the power tilt/recline feature would enable him to independently reposition himself or shift his weight to avoid skin breakdown, according to the lawsuit.
Most importantly, the wheelchair’s standing function would reduce a number of medical complications faced by Bradley, including pressure on his internal organs, the risk of scoliosis, the loss of bone density, skin breakdown and the development of contractures secondary to prolonged sitting.
It would also provide him with the ability to participate in mobility-related activities of daily living
Bradley was denied his chair in December 2010.
Martin, of Chambers County, and Ryals, of Harris County, were similarly denied.
“We’re looking for a change in policy so folks who need this particular wheelchair with a standing feature can get it,” said Maureen O’Connell, attorney for the plaintiffs. “It’s unbelievable what it can do for people.”
The plaintiffs are requesting their wheelchairs as well as a change in HHSC policies regarding durable medical equipment, said O’Connell, who described the lawsuit as the first of its kind in Texas.
Stephanie Goodman, spokesperson for HHSC, would not comment directly on the case.
She did, however, comment in general on HHSC’s equipment policies.
“We’re always in the process of re-evaluating those things,” said Goodman. “It’s something we’ll continue to look at.”
